The use of methamphetamine has increased dramatically in recent years in the United States, Europe, Canada, Australia, and Asia. The United Nations Office on Drugs &Crime (2004) reports large increases in methamphetamine production and abuse in China. However, little epidemiologic data from community-based studies is currently available to examine the nature and extent of methamphetamine abuse in China. This R21 application, "Community-based study on methamphetamine use &HIV risk in China," is submitted in response to the International Research Collaboration on Drug Addiction (PA-07-310) announcement. The project's overall aim is to identify and describe drug abuse and HIV risk-related behaviors among methamphetamine users in China, using qualitative and quantitative methods. The long-term goal of this project is to develop a theory-based HIV risk-reduction intervention for methamphetamine users in the urban areas of China. Ethnographic methods, including interviews with 40 methamphetamine users, will generate descriptive data on methamphetamine abuse and HIV risk. In addition, Respondent-Driven Sampling (RDS) will be used to recruit 300 methamphetamine users from provincial capital city Changsha in the Hunan Province located in the Central South China for a structured survey. The sample will be followed at 3-months after the baseline interview. The specific aims of the study are to: 1) Describe key dimensions in drug use practices and HIV risk behaviors among methamphetamine users in China, using ethnographic/qualitative methods. 2) Examine methamphetamine users in the Central South China on patterns of methamphetamine use, patterns of other drug use, and factors associated with drug use, health problems, treatment utilization, barriers to treatment, and criminal involvement, and to examine changes in drug use practices, health status, treatment utilization, and social problems over a three-month period. 3) Identify HIV risk behaviors among Chinese methamphetamine users over a three-month period. And 4) generate data to develop an HIV risk reduction intervention for Chinese methamphetamine users. This study is significant: 1) Little is known about the nature and extent of methamphetamine abuse, as well as HIV risk behaviors among methamphetamine users in Central South China. 2) Findings from the proposed study will be used to develop the first theory-based HIV risk reduction intervention that is culturally sensitive for Chinese methamphetamine users. The proposed study is innovative because 1) It will be the first community based study of methamphetamine abuse in China. 2) It will be the first study of methamphetamine use and HIV risk using data from Central South China, which has serious substance abuse problems. 3) It applies respondent-driven-sampling (RDS) to recruit methamphetamine users. Thus, the sample will be more representative of the target hidden population, compared with traditional outreach approaches. PUBLIC HEALTH RELEVANCE: This study will explore the role of methamphetamine abuse in HIV risk behaviors in Central South China. Specifically, through the exploration of initiation experiences and recent patterns of use, we will explore the ways in which methamphetamine use shapes the social patterning of HIV risk in China. The findings from this study will enable the development of a culturally-sensitive, theory-based HIV risk reduction intervention.